Tracheal collapse is a chronic, progressive condition and a common cause of coughing in small breed dogs. The aim of this study was to evaluate the outcome of cases of surgically managed tracheal collapse using either extraluminal prostheses or intraluminal stents.

Fourteen cases of canine tracheal collapse managed either with extraluminal prostheses or intraluminal stents were recruited from three referral centres. The majority of these cases were Yorkshire Terriers (86%). Median onset of clinical signs and age at surgery was 2.6 years and 4.5 years respectively. The most frequent clinical signs were a honking cough (79%), inspiratory stridor or stertor (71%) and exercise intolerance (71%). Concurrent medical conditions associated with the tracheal collapse were obesity (36%), dental disease (29%), cardiac disease (29%), infectious tracheobronchitis (14%) and bronchitis or tracheitis (14%). Eight (57%) cases were managed with placement of prosthetic extraluminal rings and six cases (43%) were managed using intraluminal stents (cobalt alloy Wallstent or nitinol alloy Ultraflex stent). The primary reason for surgical intervention was recurrent clinical signs despite medical management (71%). The incidence and type of complications varied between the two methods employed. Complications following extraluminal prosthesis placement included pneumonia (38%), laryngeal paralysis (25%), tracheal necrosis (13%) and detachment of extraluminal sutures (13%). The most frequent complications associated with intraluminal stent placement were collapse adjacent to stented section of trachea (33%), mucociliary disruption (33%), stent migration (33%), need for temporary tracheostomy tube placement (33%), stent deviation (17%), pneumomediastinum (17%) and tracheal perforation (17%).

The outcome of each case was assessed at various time points up to 34 months after surgery. A quantitative value was assigned to the clinical signs and a status score was then generated to allow comparison of the two treatment groups. Prior to surgical management mean status scores for both groups were similar, intraluminal stents (4) and extraluminal prostheses (3.625). Most cases showed an improvement in clinical status following surgery but dogs in the extraluminal treatment group had significantly greater improvement scores in the medium-term follow up period, 1-2 weeks post-surgery (9) and 2-weeks to 2-months post surgery (9) compared with the intraluminal treatment group, 1-2 weeks post-surgery (3.33) and 2-weeks to 2-months post surgery (7). However in the long-term follow-up period (up to 1 year post-surgery), mean scores did not significantly differ between the two groups, intraluminal stents (9) and extraluminal prostheses (9).

Results from this study suggest that both extraluminal prostheses and intraluminal stenting are effective treatments for canine tracheal collapse but neither technique is significantly better than the other in the long-term. Both techniques are associated with some morbidity with different complications being recognised.